title: Kidney function: glomerular filtration rate measurement with MR renography in patients with cirrhosis.
abstract: OBJECTIVE
  To assess the accuracy of glomerular filtration rate (GFR) measurements obtained with low-contrast agent dose dynamic contrast material-enhanced magnetic resonance (MR) renography in patients with liver cirrhosis who underwent routine liver MR imaging, with urinary clearance of technetium 99m ((99m)Tc) pentetic acid (DTPA) as the reference standard.
  
  
  METHODS
  This HIPAA-compliant study was institutional review board approved. Written informed patient consent was obtained. Twenty patients with cirrhosis (14 men, six women; age range, 41-70 years; mean age, 54.6 years) who were scheduled for routine 1.5-T liver MR examinations to screen for hepatocellular carcinoma during a 6-month period were prospectively included. Five-minute MR renography with a 3-mL dose of gadoteridol was performed instead of a routine test-dose timing examination. The GFR was estimated at MR imaging with use of two kinetic models. In one model, only the signal intensities in the aorta and kidney parenchyma were considered, and in the other, renal cortical and medullary signal intensities were treated separately. The GFR was also calculated by using serum creatinine levels according to the Cockcroft-Gault and modification of diet in renal disease (MDRD) formulas. All patients underwent a (99m)Tc-DTPA urinary clearance examination on the same day to obtain a reference GFR measurement. The accuracies of all MR- and creatinine-based GFR estimations were compared by using Wilcoxon signed rank tests.
  
  
  RESULTS
  The mean reference GFR, based on (99m)Tc-DTPA clearance, was 74.9 mL/min/1.73 m(2) ± 27.7 (standard deviation) (range, 10.3-120.7 mL/min/1.73 m(2)). With both kinetic models, 95% of MR-based GFRs were within 30% of the reference values, whereas only 40% and 60% of Cockcroft-Gault- and MDRD-based GFRs, respectively, were within this range. MR-based GFR estimates were significantly more accurate than creatinine level-based estimates (P < .001).
  
  
  CONCLUSIONS
  GFR assessment with MR imaging, which outperformed the Cockcroft-Gault and MDRD formulas, adds less than 10 minutes of table time to a clinically indicated liver MR examination without ionizing radiation.
  
  
  BACKGROUND
  http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101338/-/DC1.
authors.affiliation: Department of Radiology, NYU Langone Medical Center, New York, NY, USA. pierre-hugues.vivier@chu-rouen.fr
authors.forename: Pierre-Hugues
authors.initials: PH
authors.lastname: Vivier
authors.forename: Pippa
authors.initials: P
authors.lastname: Storey
authors.forename: Henry
authors.initials: H
authors.lastname: Rusinek
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Zhang
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Kristopher
authors.initials: K
authors.lastname: Tantillo
authors.forename: Umer
authors.initials: U
authors.lastname: Khan
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Lim
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.forename: Devon
authors.initials: D
authors.lastname: John
authors.forename: Lewis W
authors.initials: LW
authors.lastname: Teperman
authors.forename: Hersh
authors.initials: H
authors.lastname: Chandarana
authors.forename: Kent
authors.initials: K
authors.lastname: Friedman
authors.forename: Judith A
authors.initials: JA
authors.lastname: Benstein
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Skolnik
authors.forename: Vivian S
authors.initials: VS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007677:Kidney Function Tests; D007700:Kinetics; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D018709:Statistics, Nonparametric; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate